USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1938 > Part 17
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(or) WIFE of
(Give maiden side of wife in full)
Twee 1
(Husband's name in full)
Ward
(If U. S. War Veteran,
specify WAR)
(Usual place of abode)
Length of residence in city or town where death occurred
42 Ts.
mos.
days.
How long in U. S., if of foreign birth?
yrs.
(Registrar)
A TRUE COPY, ATTEST:
(Cemetery)
(City or town)
1
No
3 SEX
---------
Statement of occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 ycars or over. If the occupation had been given up or changed on account of the disease causing death, report the oceupation prior to illness. If the deceased had retired from business, report the occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only oceupation was that of home housework, write housework in answer to Question 8 and own home in answer to Question 9. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation what- ever write none.
To be complete, an occupation return must state:
8 .- The trade, profession, or particular kind of work done.
9 .- The industry or business in which the work was done.
10 .- The month and year the deceased last worked at the occupation.
11 .- The number of years the deceased followed the occupation.
In stating the occupation, avoid the use of such indefinite terms as "employee," 'worker." "operative," etc. Find out the parti- cular kind of work done and return that, as spinner, weaver, etc.
In stating the industry or business, avoid the use of such general terms as "store," "factory," "mill." ete. State the particular kind of store, factory, mill, etc., as grocery store, soap factory, collon mill, etc.
Distinguish carefully the different kinds of engincers by stating the full descriptive titles, as civil engineer, mechanical engineer, mining engineer, stationary engineer, etc. Avoid the term "laborer" when a more precise statement of the occupation can be secured. Do not use the word "mechanic, " but give the exact occupation, as carpenter, painter, machinist, etc. Distinguish carefully between retail merchants and wholesale merchants. A person who scils goods should be called a salcsinan and not a clerk.
Statement of cause of death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, namne earlier morbid conditions, if any, related to the principal eause and any important complication of the principal eause. Under contributory causes of importance not related to principal cause, name other important diseases.
Example
The principal cause of death and related causes of importanee in order of onset were as follows: Arteriosclerosis ....
Date of onset
FOIS
Chronic interstitial nephritis
1921
Cerebral hemorrhasc
July 5, 1927
Contributory causes of importance not related to principal cause:
In a group of causes containing the principal cause and related causes, the causes should be given in the order of onset, so that in a group of three causes the principal cause may appear in either first, second, or third position. The principal cause in the above example happens to be the second cause given.
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forth- with, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belicf the name of the deceased, his supposed age, the discase of which he died, defined as required by section onc, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death .... Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or froin one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satis- factory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thercof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from cne town to another within the common- wealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such re- moval; provided, that such hody shall be returned to the town from wl:ich it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as re- quired by section ten of chapter forty-six, that the deccased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require. - Chap. 114, Sec. 45, G. L., (Tercentenary Edition.)
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence .... Gen. Laws, Chap. 38, Sec. 6.
.... He shall in all cases certify to the town clerk or registrar in the place where the deceased dicd his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .- Gen. Laws, Chap. 38, Scc. 7.
No undertaker or other person shall bury a human body er the ashes thereof which have been brought into the commonwealth until he lias received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the ceme- tery or burial ground in which the interment is made .... Chop. 114, Sec. 46, G, L., (Tercentenary Edition.)
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observanos of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease un- related to any form of injury, have died without recent medical attend- ance er whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
RI R-302
tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very
important.
50m-9-'31. No. 3385-K
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED
1/12/38
19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
1999-2-37
19
., to.
2/7/38
19
I last saw
alive on.
1/2/38
to have occurred on the date stated above, at ... .. m.
The principal canse of death and related causes of importance in order of onset were as follows:
... ofwhosse.of ... liver ..... type ...
Dateofonset c/37
Contributory causes of importance not related to principal cause:
Name of operation
Date of
What test confirmed diagnosis?
Was there an autopsy?
20 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed)
M. D.
(Address) .. ">
Date /2.
19
21 PLACE OF BURIAL,
CREMATION OR REMOVAL ...... 3.1.11.02.
(Cemetery)
DATE OF BURIAL
1/11/20
19
22 NAME OF
UNDERTAKER
ADDRESS
Received and filed 19
FEB 1-4 1930
(Registrar of City or Town where deceased resided)
1
PLACE OF DEATH
SUFFOLK County )
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No.
249
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME Terje Andrea
(If deceased is a married, widowed or divorced woman, give also maiden name.)
specify WAR)
(a)
Residence.
No.
(Usual place of abode)
25-Charles
.St.,.
. Ward,
(If nonresident; give bity or town and state)
Length of residence in city or town where death occurred
yrs.
mos.
days.
How long in U. S., if of foreign birth?
yrs.
mos. days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
5a If married, widowed, or divorced
HUSBAND of
Sarah Tucker:
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7 AGE
Years A. Months .57 Days
If less than 1 day .Hours Minutes
OCCUPATION
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc .... 9 Industry or business in which work was done, as silk mill, saw mill, bank, etc.
Sales tr
fruit store
10 Date deceased last worked at
this occupation (month and 1/37
year)
11 Total time (years) spent in this occupation ... 44
12 BIRTHPLACE (City) (State or country)
13 NAME OF
FATHER
PARENTS
14 BIRTHPLACE OF FATHER (City) (State or country)
15 MAIDEN NAME
OF MOTHER
Stelle Choice
16 BIRTHPLACE OF MOTHER (City) (State or country)
17 leformant invited Harris sister
(Address)
MARGIN RESERVED FOR DIN
-
IN. D.
(City or Town)
No. Pater Bout .. Butghow Hoop .... ..... St., .........
Ward
( U. S.
War Veteran,
36
(Give maiden name of wife in full)
1'9
death is said
y of town)
R-302
OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very
important.
50m-9-'31. No. 3385-g
17
Informaat Husband
(Address)
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED 19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)]
Jan 12/38
(Day)
19 I HEREBY CERTIFY, That I attended deceased from
12/14/37
,19
., to ..
1/12/38
....... , 19.
I last saw her
... alive on
1/12/58
19 death is said
to have occurred on the date stated above, at ....... " ... m.
The principal cause of death and related causes of importance in order of onset were as follows:
Dateofonset
carcinomatosic -metastatio from
"left breast
Styro
"broncho pneumonia
Contribatory causes of importance not related to principal cause:
rheumatoid arthritis mario
"Strumpell type 17yra patent ductus arterosis 41yrs
Sem ivaation Escence ift breast
Date of ...
What test confirmed diaghostsec.tomy
yes
20 Was disease or injury in any way related to occupation of deceased? If so, specify.
(Signed)
M. D.
(Address)
R T Phillips
R B B Hosp
Date ...
1/13/88
19
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Orqent .. Shalom
(City or town)
DATE OF BURIAL
1/14/50
19
22 NAME OF
UNDERTAKER
B.F.Solomon
ADDRESS
Brookline
Received and filed
1/15/38
19
(Registrar of City or Town where deceased resided)
1
PLACE OF DEATHI
SUFFOLK DOSTON
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
FOLK
.ON
{(City or town making return)
Registered No ...
377
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Joan ..... Croan
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence.
No .....
44 Trident Ave
.St., ..
...... Ward, Winthrop
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred
yrs.
mos.
days. How long in U. S., if of foreign birth?
yrs.
mos. days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
(write the word)
5 SINGLE
MARRIED
WIDOWED
or DIVORCED arried
5a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of Frank Groan lusband's name in full)
6 IF STILLBORN, enter that fact here.
7 AGE 41 Years .. Months 2.1 ..... Days
If less than 1 day
.Hours
.Minutes
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc. at home
OCCUPATION
9 Industry or business in which work was done, as silk mill, saw mill, bank, etc.
10 Date deceased last worked at this occupation (month and year)
11 Total time (years)
11/37
spent in this occupation ...... 1.3
12 BIRTHPLACE (City) (State or country)
Phillipsburg Poma
13 NAME OF FATHER Jacob Snyder
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country) Russia
15 MAIDEN NAME
OF MOTHER
Mollie Abramson
16 BIRTHPLACE OF MOTHER (City) .. (State or country) Russia
...
tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE ....
No Robert ... Brook Brigham Hosp. .....
St.,
Ward
(If U. S. War Veteran, specify WAR)
37
(Usual place of abode)
(Year)
R-302
SUFFOLK
(County) BOSTON
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No ...
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Revillo .. H. Mason
(If deceased is a married, widowed or divorced woman, give also maiden name.)
specify WAR)
(a)
Residence. No.
(Usual place of abode)
33.Orlando Av
.St., ............
Ward,
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred
yTs.
mos.
days.
How long in U. S., if of foreign birth?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Marr
5a If married, widowed, or divorced HUSBAND of
Emily E Kenney
(Give maiden name of wife in full)
(or) WIFE of (Husband's name in full)
G IF STILLBORN, enter that fact here.
7
AGE
55
Years 7 Months .26 Days
If less than 1 day Hours .. Minutes
OCCUPATION
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc ....
postal clerk
9 Industry or business in which
work was done, as silk mill,
R R Post Office
saw mill, bank, etc.
10 Date deceased last worked at
this occupation (month and
year)
12/37
11 Total time (years)
spent in this
occupation.
35
12 BIRTHPLACE (City)
(State or country)
Upton
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country) Upton
15 MAIDEN NAME
OF MOTHER
Firma A Mason ok
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Warren R I
17
wife
Informant
(Address)
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED
2/17/38
19
MEDICAL CERTIFICATE OF DEATHI
18 DATE OF
DEATH
Famonths/38
(Day)
19
.. , to
19
I last saw
2
1m
2/14/38
to have occurred on the date stated above, at. m.
The principal cause of death and related causes
onset were as follows:
Datesfonset
pancreatitis
5
mo
Contributory causes of importance not related to principal cause:
pneumonia
2 da
Name of operation
WhatdesPednfl Ahed diagnosispancreas
Wlamer h auto .3/38
20 Was disease or injury in any way related to occupation of deceased?
If so, specify
M. D.
(Signed)
(Address)
A L. Davis
Date
19
21 PLACE OF BURIAL,
BURIAL, Commonwealth Av
CREMATION OR REMOVAL
2/15
38
DATE OF BURIAL
(CityoBewUpton
19
22 NAME OF
UNDERTAKER
G Wl Full & Sons
ADDRESS
Received and filed 19
MAR JI 1938
(Registrar of City of Town where deceased resided)
-
tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very
important.
50m-9-'31. No. 3385-g
1
PLACE OF DEATH
No.Palmer ... Momoria.l ... Hosp ....
St.,
Ward
(L U. S.
War Veteran,
38
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
2/11/38
death is said
11.13 5Amportance in order of
13 NAME OF FATHER Herbert E Mason
Fall
Date of
2/17/38
301A
N R WRITE PIAINI Y. WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every itemsel informa- important. See instructions and extracts from the laws on back of certificate. in plain terms, so that it may be properly classified. Date of onset and exact statement of OCCUPATION are very
100m 1136 No. 9080 F
I HEREBY CERTIFY that e satisfactory standard certificate of death was filed withme BEFORE the burial or transit permit was Issued: Www. D. Children. (Signature of Agent of Board of Health of other) Health Puces 3/4/38 official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
march
(Month)
(Day)
2 1938
(Year)
19 I HEREBY CERTIFY, That ! attended deceased from January- 20 19.08. 10. March 2- 1938 i last saw b .... .. 1 ... alive on March 2 19.3.8 ... , death is sald to have occurred on the date stated above, at 4,019-m.
The principal cause of death and related causes of Importance In order of onset were as follows:
Dele of Onset IMPORTANT
... 1
arTerio- Sclerosis
years
Contributory causes of Importance not related to principal cause:
Broncho- PNEUMONIA
Feb-27-
Name of operation ..
0
What test confirmed dlagnosis?
Date of.
Was there an autopsy? No.
20 Was disease or Injury in any wayrelated to occupation of deceased? NO
If so, specify
Edward à Jourgen
M. D.
(Signed)
(Add 200 Ufacturation Probate May 2 1938 Nalyhard Brooksline 21
22 NAME OF
UNDERTAKER
Oir Warren SY Rent
ADDRESS
Received and flled. 19
MAR
(Registrar)
1
PLACE OF DEATH
(County) Winthrop /(City or Town) Winthrop Community Streportal No. man
41.86 The Commonwealth of Alassachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent. 33
Registered No. J (If death occurred in a hospital or institution, Ward [ give its NAME instead of street and number) (If U. S. War Veteran
2 FULL NAME
(If deceased iskamarried, widowed or divorced woman, give also maiden me blindall specify WAR)
(a) Residence. No. 34 Mendes
( Usual place of abode)
Length of residence in city or town where death occurred years 2 months
12 days.
How long in U.S., if of foreign birth?
years
months days.
PERSONAL AND STATISTICAL PARTICULARS
3. SEX ..
4 COLOR OR RACE
Temalı White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Single
5a If married, widowed, er divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7 74 AGE .. Years. .Months .Days
If less than 1 day Hours .. Minutes
OCCUPATION
8 Trade, profession, or particular kind ofwork done, as spinner, sawyer, bookkeeper, etc ...
at stam
9 Industry or business in which work was done, as ailk mill. saw mill, bank, etc ...
10 Date deceased last worked at
11 Total time (years)
spent in this
occupation.
12 BIRTHPLACE (City)
(State or country)
-
non
2
13 NAME OF
FATHER
Jeremiah Regar
PARENTS
14 BIRTHPLACE OF FATHER (City) (State or country)
Wieland
15 MAIDEN NAME OF MOTHER Cannot be Learned
16 BIRTHPLACE OF MOTHER (City) (State or country) Queland
17 Jeformant .. (Addr
Thomas B. Regan (Hephey Relation, Mł any Place of Burial, Genation or Removal. (City or Town) DATE OF BURIAL. 1938
J. Began
St.
.Ward,
Burton
( If nonresident, give city or town and statc)
........
this occupation (month and
year)
Statement of occupation. -- Precise statement of occupation is very important, so that the relative healthfulness of various pur- suits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the occupation prior to illness. If the deccased had retired from bus- iness, report the occupation prior to retirement. Children not gainfully employed may be returned as AT SCHOOL Or AT HOME. For a woman whose only occupation was that of home housework, write HOUSEWORK in answer to Question 8 and OWN HOME in answer to Question 9. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as HOUSEKEEPER-PRIVATE FAMILY, COOK-HOTEL, etc. For a person who had no occupation whatever write NONE.
To be complete, an occupation return must state :
8 .- The trade, profession, or particular kind of work done. 9 .- The industry or business in which the work was done.
10 .- The month and year the deceased last worked at the occupation.
11 .- The number of years the deceased followed the occupation. "
In stating the occupation. avoid the use of such indefinite terms as "employee," "worker." "operative," etc. Find out the partic- ular kind of work done and return that, as SPINNER, WEAVER, etc.
In stating the industry or business. avoid the use of such gen- eral terms as "store." "factory," "mill," etc. State the particular kind of store, factory, mill, etc., as GROCERY STORE, SOAP FACTORY, COTTON MILL. ctc.
Distinguish carefully the different kinds of engineers by stating the full descriptive titles, as CIVIL ENGINEER, MECHANICAL ENGIN- EER, MINING ENGINEER, STATIONARY ENGINEER, etc. Avoid the term "laborer" when a more precise statement of the occupation can be secured. Do not use the word "mechanic," but give the exact occupation, as CARPENTER, PAINTER. MACHINIST, etc. Distinguish carefully between RETAIL MERCHANTS AND WHOLESALE MERCHANTS. A person who sells goods should be called a SALESMAN and not a CLERK.
Statement of Cause of Death. -- Cause of death means the disease, or complication which causes death, NOT the mode of dying, E. G., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause. Under contributory causes of importance not related to principal causc, name other important diseases.
Example
The principal cause of death and related causes of importance in order of onset were as follows:
Date of Onset
Arteriosclerosis
1915
Chronic interstitial nephritis
1921
Cerebral hemorrhage
July 5. 1927
Contributory causes of importance not related to principal cause :
In a group of causes containing the principal cause and related causes, the causes should be given in the order of onset, so that in a group of three causes the principal cause may appear in either first, second, or third position. The principal cause in the above example happens to be the second cause given.
with, atter the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his sup- posed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death. . . . GEN. LAWS, CHAP. 46, SEC. 9.
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